Even with Obamacare, a free clinic in Harrisburg is as busy as ever

(Harrisburg) — More than 670,000 low-income Pennsylvanians have been able to receive health care coverage through the federal Affordable Care Act’s Medicaid expansion.

Hundreds of thousands of others have purchased insurance on the exchange, with mixed results.

The commonwealth is in the top 10 in the country for rate of uninsured.

But more than six percent of the population still doesn’t have coverage.

So, some faith-based organizations are filling in the gaps.

At one free clinic in Harrisburg, nurses tallied 14,000 visits last year.

Christ Lutheran Church sits on busy South 13th Street in Harrisburg’s Allison Hill, a neighborhood that is home to many low-income people.

Look down, and there’s yellow feet painted on the sidewalk, step by step.

They wrap around the church to a back alley.

Take the stairs down, and you arrive at Holy Spirit Hospital’s Medical Outreach Service, in the basement of the church.

Christ Lutheran was once the place to be seen for the movers and shakers in Harrisburg.

That time has come and gone.

Now it’s the place to be seen…by a nurse.

“I am somebody, don’t be deceived by this shirt and tie and Brooks Brothers suit, I am below the poverty level and all of these things impact me,” says 68-year-old William Holland.

He lives across the street, and says he sits right at the poverty level, making about $12,000 a year.

“I’m a chronic smoker. Vanessa and Alicia are always telling me, ‘You gotta slow down on this, focus on that’,” he says.

William gets government help for health care, but the staff at the clinic can spend more time with him than other doctors who need to keep moving from patient to patient.

Vanessa Garcia is the Vanessa he talks about – the one helping him improve his health.

“I love culture and I love language and I love difference,” she says.

“I don’t want to be with everybody who is just like me. For me, it’s a challenge. It’s a challenge for you to trust me, I have to earn that trust.”

Vanessa has worked at the clinic for a dozen years.

She says some days she goes home crying.

Other times, she’s overjoyed at the progress a patient has made.

She’s someone special to William.

“That’s a big thing for us. I will sit like this, and listen to Bill,” she says.

They go on walks together, as part of the clinic’s weight loss program.

And sometimes, they just spend time with each other.

As William says, “They talk to you like a brother or sister would. More on their level. They’re interaction is genuine and sincere.”

Vanessa agrees: “We meet people where they are in life. If you come in and you don’t know how to write, we’ll work with you.”

The clinic serves a wide variety of people – undocumented immigrants for one, but also people who just lost their job and their insurance, those who feel overwhelmed by the health system as a whole, or others who aren’t eligible for government coverage.

“Word of mouth. Word of mouth is how word is passed in this community. We don’t do any advertising. We don’t need to do that. We have enough clients,” says Reverend Jody Silliker, the director of medical outreach for Holy Spirit Health System, who co-founded the clinic 23 years ago.

She had just a simple blood pressure cuff and a first aid kit in a soup kitchen.

“In that first year, 357 people came,” she says.

“We determined we wanted to develop what people were asking for, rather than us coming in and saying we know what you need. Over 14,000 patient visits last year.”

Beyond the basic visits with a nurse who’s available five days a week, there are also dental services, prenatal care, and even urgent care provided about once a week.

Holy Spirit pays for the full-time staff at the clinic, but Christ Lutheran relies on lots of volunteers and donations to keep it running.

Silliker says the free clinic is likely saving the health care system money.

If people instead walked in to the expensive emergency room without insurance, those costs would be paid by much of society, either through tax dollars or private insurance premiums.

William Holland says for years, he was told by medical professionals – cut out the junk food, stop smoking, and get yourself in shape.

But at Holy Spirit’s Medical Outreach clinic in Harrisburg, Vanessa Garcia approached him differently.

He once told her that he considers himself an old-school Jaguar with a lot of miles.

He recounts the story: “She said, ‘Bill you know, Jaguars take premium gas, you gotta leave that junk food alone.’ It stuck and it made a difference.”

The respect goes both ways.

Vanessa says every patient, every encounter, means something to her too.

“If Bill holds his hand out and I’m going to check his blood sugar, that’s rewarding. He trusted me,” she says.

For those left behind by the health care system, the free clinic is – as Bill puts it – an “oasis in a desert of poverty.”

If a repeal of the Affordable Care Act leaves hundreds of thousands without Medicaid, more people may look to free clinics and other nonprofits to help out.

Reverend Jody Silliker says they’re busy enough as it is.